This document provides a high-level overview of the changes in DSG version 9.0.2025.

1. New information: Separation of technical submission instructions into the Arkansas HTI Technical Reference Guide (TRG).

2. Updated requirement: Lookup data are no longer required for submission if specialty codes (MC032, MC212) are taxonomy codes and/or CMS Medicare codes.

3. Updated requirement: Formerly proposed future data for pharmacy benefit managers and supplemental files have been removed and will not be implemented.

4. Updated requirement: Updated and/or clarified definitions for many data elements, including but not limited to:
   a. Control counts criteria
   b. Closed enrollment criteria
   c. Prohibition of the use of system default dates
   d. Value alignment when the same data element is found across file types
   e. New or revised dependencies

5. Updated requirement: Data integrity audit (DIA) data requirements have been removed (this has been replaced by internal processes).

6. Updated requirement: Updated appendices with refreshed links.

7. Updated requirement: Removal of unused data elements from all claim types. These are replaced with placeholder data elements.

8. New requirement: Addition of new data elements for all claim types to align with the APCD Council Common Data Layout.

9. New requirement: Many data elements that were formerly labeled optional are now required.

10. New requirement: Inclusion of denied claim lines and new data elements to support denied claims processing.

11. New requirement: Inclusion of Non-Claims Payments requirements as a new file type. See the Arkansas HTI Supplemental Data Submission Guide Data (SDSG) document.

12. New requirement: Inclusion of Pharmacy Rebate data requirements as a new file type. See the Arkansas HTI Supplemental Data Submission Guide Data (SDSG) document.

The Data Submission Guide (DSG) provides instructions and requirements for submitting data to the Arkansas HTI. It outlines the format, structure, and other details that submitting entities need to follow to ensure that their data is accepted and processed correctly.

The document identifies changes, existing and new, in the Revision History section and on the page where the revision occurs. This enables the submitting entity quick and easy identification of the changes.

Update: Inclusion of items listed below under Technical Changes Needed Identified by Carriers.

This document format is the same as above but without comments. Changes are identified in the Revision History section only.

Update: Inclusion of items listed below under Technical Changes Needed Identified by Carriers.

This Technical Reference Guide (TRG) complements the DSG by providing guidance on technical aspects of data submissions. Much of this information was previously included in the DSG. While its content may be broadly helpful to any submitting entity's (SE) team, it is specifically intended for technical staff responsible for data file generation, data security, and data transfer.

This document includes versioning instructions and as well as requirements for denied claim processing.

Update: Inclusion of items listed below under Technical Changes Needed Identified by Carriers.

The Supplemental Data Submission Guide (SDSG) provides instructions and requirements for submitting non-claims-based data and pharmacy rebate data to the Arkansas HTI. It outlines the format, structure, and other technical details that submitting entities need to follow to ensure their data is accepted and processed correctly. It should be used with the TRG to ensure secure and timely data submission.

The version provided here contains comments for revisions for changes made since the public comment period in October 2025.

This layout is for data submitters only. Reach out to the AR APCD Technical Support Team for the correct data layout spreadsheets during the onboarding process.

As carriers are putting DSG 9 changes into place, some technical requirements will be identified as needing clarity or correction. This section will contain a dynamic list of changes that should be reviewed and incorporated.

1. For ME049 (Member Deductible), the definition will be clarified to indicate that the value in this field should be for ALL benefit types that the member has, not just medical, pharmacy, and dental.

2. The requirement threshold for ME068 (Cost-Sharing Reduction Code) should read as 100% when ME122 <> Y.

3. Revision 19 indicates that PC052 - Prescribing Physician Street Address 2 should be removed. This is incorrect. It should be kept as a placeholder and not populated.

4. The DC704 threshold refers to MC706 but should refer to DC706

5. Added wording to service provider location fields to clarify that the value represents the location were services was rendered:

   1. MC108 - Service Provider Address

   2. MC033 - Service Provider City

   3. MC034 - Service Provider State

   4. MC035 - Service Provider Zip

   5. DC027 - Service Provider City

   6. DC028 - Service Provider State

   7. DC029 - Service Provider Zip

6. Corrected typo in Format requirement for PR004 - Performance/Reporting Period End Date. The current format = YYYYMMD and should be YYYYMM

7. The PC075 length is currently set to 2 bytes but should be 3 bytes.

8. The PV028 field was removed in DSG 9 but is not listed on page xii as being removed. This field should not be included in submissions for DSG 9.0.2025.

9. The value AHEC for ME125 should be ‘Arkansas Higher Education Consortium’ not 'Area Health Education Center.

10. The dependency rule for PV057 is incorrect. It currently reads ‘100% if PV002 <> 1’. It has been corrected to ready ‘100% if PV003 <> 1’.

11. DSG 9 requires the use of NULL to mean unknown for Marital Status (ME062). In all previous DSGs this has been represented using a U. The AR APCD team is changing it back. Use U to mean unknown for Marital Status (ME062).

12. Requirements change for Denied Claim Indicator fields (MC123, PC123 and DC123): The values for these fields are 1 and 0. The current requirements for these fields includes a dependency on Claim Status fields (MC038, PC138, DC138). Denied Claim Indicator is set to 1 when Claim Status field values are 04 or 23. This requirements infer that the field should be NULL if the dependency is not met. New requirements remove the dependency to enable the value 0 to be populated. However, the value 1 should only be present when Claims Status is 04 or 23.

13. There should be no overlap between pharmacy rebate data and non-claims based payment data. The pharmacy related requirements for the non-claims based data files are not rebate related.  They focus on pharmacy related alternative payments paid to providers, not rebates paid by manufacturers and PBMS to carriers or pharmacies.

14. Versioning requirements in the TRG have been updated to include this assumption: Submit all claim lines if a claim is modified in anyway from a occurrence in a previous submission. Do not submit just the affected claim line; the entire claim is necessary for proper versioning. NOTE, this is not a change in versioning requirements, it is a clarification of the documented assumptions.

15. Denied claim requirements in the TRG have been updated to include this assumption: Submitting entities should include all claim lines associated with a claim containing a denied claim line. Do not submit just the affected claim line(s); the entire claim inclusive of all claim lines is necessary for proper denied claim processing.

16. Dependency change on PC126 from 100% if PC138 = 04 or 23, to 100% if PC123 = 1.